Pain and Pain Experience

This is a slightly more polished version of a presentation I wrote for the Author-Meets-Critics session on Colin's book at the Eastern APA session on Jan 4, 2017, in Baltimore. I’ve decided to post this commentary online pretty much as is -- I am afraid I don't have time to prepare a version suitable for publication. I hope the reader will find it helpful. At any rate, please treat this piece as a rough draft originally intended to be delivered to (...) a live audience. Although my commentary is mostly critical, I admire Colin's book for its originality, breadth, and depth. It stimulated my thought like no other books in recent years. (shrink)

[Special issue honoring Nikola Grahek] Representationalism in philosophy of perception has become more or less the dominant view. There are various versions of it not all of which are motivated by the same set of concerns. Different metaphysical and epistemological agendas are at work in different strands of the movement. In this paper, I will focus on what has come to be known as strong representationalism. This view has reductive and non-reductive versions, which are usually paired with realist and irrealist (...) versions respectively. First, I will develop a simple, largely empirical, argument against the realist reductive version. Later, rather more briefly, I will extend the argument to cover irrealist representationalism. (shrink)

Bodily (dis)pleasures and emotions share the striking property of being valenced, i.e. they are positive or negative. What is valence? How do bodily (dis)pleasures and emotions relate to one another? This chapter assesses the prospects of two popular theses regarding the relation between bodily (dis)pleasures and emotions in light of what we can reasonably think about valence. According to the first thesis, the valence of bodily (dis)pleasures is explanatory prior vis-à-vis the valence of emotions. According to the second, emotions contain (...) bodily (dis)pleasures. I argue that bodily (dis)pleasures are intentional states whose valence is to be understood in terms of evaluative experience, and bring to light the similarities and dissimilarities between their intentional structure and that of emotions. On this backdrop, I offer reasons to conclude that we should adopt neither of the two theses. (shrink)

Evaluativism about unpleasant pains offers one way to think about unpleasant pain experience. However, extant Evaluativist views do not pay enough attention to the affective dimension of pain experience and the complex relations between the affective, evaluative and sensory dimensions. This paper clarifies these relations and provides a view which more closely reflects the phenomenology of unpleasant pains. It argues that the intentional structure of paradigmatic unpleasant pain is as follows: unpleasant pains essentially involve a proprietary intentional mode—what I call (...) affective-interoception—and a distinctive kind of evaluatively qualified sensory content. The resulting view is Affective-Evaluativism. (shrink)

This work proposes that pain meets the requirements of being characterized as a secondary quality, as it covers, like a color, a determined extension. The argument seeks to establish a literal pain-color analogy through an inquiry into the intensity and location of the pain. From the classic intensity/location relationship reported by patients with acute appendicitis, three degrees of pain are distinguished: mild, moderate, and severe. The objective is only achieved by examining the Body’s extensional determinations (primary quality) insofar as each (...) of these degrees of pain covers three particular measures. Once these three measures have been explored according to the perforation process (tissue damage), the work ends by identifying pain as a transcendent moment. (shrink)

The aim of the article is to introduce a new concept of “pain-related bodily doubt,” which complements current concepts currently in use, such as pain-related fear, pain catastrophizing, and pain self-efficacy. This new concept, adapted from recent philosophical work on illness experience, has the potential to positively contribute to pain research and clinical practice by providing a vocabulary for clinicians and patients to discuss implicit or tacit dimensions of pain-related experiences.

Philosophers disagree about what the folk concept of pain is. This paper criticises existing theories of the folk concept of pain, i.e. the mental view, the bodily view, and the recently proposed polyeidic view. It puts forward an alternative proposal – the polysemy view – according to which pain terms like “sore,” “ache” and “hurt” are polysemous, where one sense refers to a mental state and another a bodily state, and the type of polysemy at issue reflects two distinct but (...) related concepts of pain. Implications with respect to issues in philosophy of pain are also drawn. (shrink)

Our pains can be more or less intense, our mental imagery can be more or less vivid, our perceptual experiences can be more or less striking. These degrees of intensity of conscious experiences are all manifestations of a phenomenal property I call mental strength. In this article, I argue that mental strength is a domain-general phenomenal magnitude; in other words, it is a phenomenal quantity shared by all conscious experiences that explains their degree of felt intensity. Mental strength has been (...) largely overlooked in favor of mental states’ type, representational contents, domain-specific phenomenology, or processes such as attention. Considering mental strength in our reflections about the mind illuminates debates about the relation of representational contents and phenomenal character, and it also helps address questions about the structure and functions of consciousness. Mental strength provides a unifying construct to model what is shared in the phenomenology of different types of conscious experiences. (shrink)

Dysmenorrhea, or menstrual pain, is regularly suffered by 45 to 95% of menstruating women. Despite its prevalence, and despite the philosophical importance of pain as a general phenomenon, dysmenorrhea has been all but completely overlooked in contemporary analytic philosophy of mind. This paper aims at rectifying this situation. We single out three properties of what is often considered the paradigmatic case of painful experience, what we call injury-centered pains, and argue that dysmenorrhea does not have any of them, and hence (...) that it does not neatly conform to the injury-centered model of pain. This calls into question the centrality of the injury-centered model, and suggests novel research avenues within theoretical debates on affectivity. (shrink)

Crump et al.’s contribution to assessing whether decapods feel pain raises an important question: Is pain distributed unevenly across the order? The case for pain appears stronger in Pleocyemata than in Dendrobranchiata. Some studies report pain avoidance behaviors in Dendrobranchiata (Penaeidae) shrimp, but further studies are needed to determine whether the chemicals used are acting as analgesics to relieve pain, or as soporifics to reduce overall alertness. If the latter, the most farmed shrimp species may not require the same level (...) of protection as crabs, crayfish, and lobsters. (shrink)

What is the best way to account for the badness of pain and what sort of theory of welfare is best suited to accommodate this view? I argue that unpleasant sensory experiences are prudentially bad in the absence of contrary attitudes, but good when the object of positive attitudes. Pain is bad unless it is liked, enjoyed, valued etc. Interestingly, this view is incompatible with either pure objectivist or pure subjectivist understandings of welfare. However, there is a kind of welfare (...) theory that can incorporate this view of the badness of pain and which is very, very close to being a form of subjectivism. Moreover, this hybrid account of welfare is entirely compatible with the deep motivations of subjectivism. I therefore argue that those who lean towards welfare subjectivism should adopt this account of pain, and that we should revise our understanding of subjectivism to count such theories as subjective. (shrink)

I respond to an objection recently formulated by Barlassina and Hayward against first-order imperativism about pain, according to which it cannot account for the self-directed motivational force of pain. I am going to agree with them: it cannot. This is because pain does not have self-directed motivational force. I will argue that the alternative view—that pain is about dealing with extramental, bodily threats, not about dealing with itself—makes better sense of introspection, and of empirical research on pain avoidance. Also, a (...) naturalistic theory of body-involving commands falls straightforwardly out of our most prominent naturalistic metasemantic accounts, while the token-reflexive contents that would underlie self-directed motivation are more problematic. (shrink)

The Life Worth Living investigates the exclusion of and discrimination against disabled people across the history of Western moral philosophy. Building on decades of activism and scholarship, Reynolds shows how longstanding views of disability are misguided and unjust, and he lays out a vision for an anti-ableist moral future. The introduction and first chapter are available to download here. -/- Table of Contents: Introduction: The Ableist Conflation. Part I: Pain. 1. Theories of Pain. 2. A Phenomenology of Chronic Pain. Part (...) II: Disability. 3. Theories of Disability. 4. A Phenomenology of Multiple Sclerosis. Part III: Ability. 5. Theories of Ability. 6. A Phenomenology of Ability. Conclusion: An Anti-Ableist Future. (shrink)

This article gives a short presentation of reflexive imperativism, the intentionalist theory of valence I developed with Max Khan Hayward. The theory says that mental states have valence in virtue of having reflexive imperative content. More precisely, mental states have positive valence (i.e., feel good) in virtue of issuing the command "More of me!", and they have negative valence (i.e., feel bad) in virtue of issuing the command "Less of me!" The article summarises the main arguments in favour of reflexive (...) imperativism and against other intentionalist treatments of valence. (shrink)

Various prominent theories of pain assume that it is pain’s biological function to inform organisms about damage to their bodies. I argue that this is a mistake. First, there is no biological evidence to support the notion that pain was originally selected for its informative capacities, nor that it currently contributes to the fitness of organisms in this specific capacity. Second, neurological evidence indicates that modulating mechanisms in the nociceptive system systematically prevent pain from serving a primarily informative role. These (...) considerations threaten to undermine standard perceptual and representational accounts of pain. (shrink)

This article challenges the orthodox position that some smells are pleasantly fragrant and some tactile sensations are painful. It proposes that the affective components of our experiences are a kind of illusion. Under this alternative picture, experiences that seem to have positive or negative affect never actually do. Rather, the affective component is hyper-illusory, a second-order misrepresentation of the way things actually seem to us. While perceptual hyperillusions have elicited scepticism in other contexts, affective hyperillusions can withstand common critiques. Focusing (...) on the paradigmatic affective experience — pain — the article situates the hyperillusory account within the existing scientific and philosophical literature. Several theoretical advantages of positing a hyper-illusory structure to affective experiences emerge from the discussion. (shrink)

The IASP definition of 'pain' defines pain as a subjective experience. The Note accompanying the definition emphasizes that as such pains are not to be identified with objective conditions of body parts (such as actual or potential tissue damage). Nevertheless, it goes on to state that a pain "is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience." This generates a puzzle that philosophers have been well (...) familiar with: how to understand our utterances and judgments attributing pain to body parts. (The puzzle is of course general extending to all sensations routinely located in body parts.) The present work tackles this puzzle. I go over various options specifying the truth-conditions for pain attributing judgments, and at the end make my own recommendation which is an adverbialist, qualia-friendly proposal with completely naturalistic credentials that is also compatible with forms of weak intentionalism. The results are generalizable to other bodily sensations and can be used to illustrate, quite generally, the viability of a qualia-friendly adverbialist (but naturalist and weakly intentionalist) account of perception. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

The paper aims at clarifying the distinctions and relations between pain and suffering. Three negative theses are defended: 1. Pain and suffering are not identical. 2. Pain is not a species of suffering, nor is suffering a species of pain, nor are pain and suffering of a common (proximate) genus. 3. Suffering cannot be defined as the perception of a pain’s badness, nor can pain be defined as a suffered bodily sensation. Three positive theses are endorsed: 4. Pain and suffering (...) are categorically distinct: pain is a localised bodily episode, suffering is a non-localised affective attitude. 5. Suffering can be expressed, pains cannot. As a consequence, we can have compassion for the suffering of others, not for their pains. 6. The relation between pain and suffering is akin to the relation between danger and fear, injustice and indignation, wrongdoing and guilt: suffering is the correct reaction to pain. One upshot is that both the influential view that the experience of pain is incorrigible and the influential view that the ordinary conception of pain is paradoxical are false. (shrink)

Una de las razones fundamentales por las cuales la muerte causa dolor se debe a una comprensión equívoca acerca del sentido último de la vida humana. Además, la Modernidad se desliga, en ocasiones, de la dimensión emotiva y afectiva del ser humano. Así pues, toda terapéutica del duelo mortuorio exige reflexionar con seriedad acerca del sentido de la muerte, tarea en la cual la tradición filosófica y teológica occidental es un apoyo ineludible. En la primera parte se ha de revisar, (...) desde la perspectiva filosófica de Epicuro, la concepción de la muerte según la cual la opinión ordinaria es errada y no da cabida a una vida realizada como fundamento de la tranquilidad y la salud. En la segunda parte se esbozarán los rasgos y las notas esenciales de una concepción cristiana de la muerte a partir de la obra de San Agustín de Hipona, exponiendo algunas medidas concretas de preparación para la muerte con base en su pensamiento. (shrink)

The current IASP definition of pain has come under renewed criticisms recently. There is a new momentum for its revision as reflected by the fact that IASP has now a Presidential Task Force dedicated to look into whether there is enough warrant to update the definition. I critically review all the major criticisms of the current definition in detail, and raise new difficulties rarely discussed before. I show that none of the major criticisms has enough warrant to force us to (...) substantially revise the current definition. Combined with the discussion of the new difficulties, there is nonetheless a need to restate the definition using slightly different terminology that will make the original intent of the current definition clearer and more precise. A restatement of the definition is proposed and its potential is discussed in light of some empirical questions that remain. [The IASP Council has now approved a revised definition and published its rationale here: Pain 2020 Sep 1; 161(9), pp. 1976–1982. The new definition follows (most of) my recommendations.]. (shrink)

Accounts of the nature of unpleasant pain have proliferated over the past decade, but there has been little systematic investigation of which of them can accommodate its badness. This paper is such a study. In its sights are two targets: those who deny the non-instrumental disvalue of pain's unpleasantness; and those who allow it but deny that it can be accommodated by the view—advanced by me and others—that unpleasant pains are interoceptive experiences with evaluative content. Against the former, I argue (...) that pain's unpleasantness does indeed have noninstrumental disvalue; against the latter I argue both that my critics’ own desire-theoretic accounts of pain's unpleasantness cannot accommodate such disvalue, and that my evaluativist view can—either by appealing to “anti-unpleasantness” desires or by exploiting pain's perceptuality. (shrink)

Affective experiences such as pains, pleasures, and emotions have affective phenomenology: they feel pleasant. This type of phenomenology has a loopy regulatory profile: it often motivates us to act a certain way, and these actions typically end up regulating our affective experiences back. For example, the pleasure you get by tasting your morning coffee motivates you to drink more of it, and this in turn results in you obtaining another pleasant gustatory experience. In this article, we argue that reflexive imperativism (...) is the only intentionalist account of affective phenomenology—probably, the only account at all—that is able to make sense of its loopy regulatory profile. (shrink)

Experiences like pains, pleasures, and emotions have affective phenomenal character: they feel pleasant or unpleasant. Imperativism proposes to explain affective phenomenal character by appeal to imperative content, a kind of intentional content that directs rather than describes. We argue that imperativism is on the right track, but has been developed in the wrong way. There are two varieties of imperativism on the market: first-order and higher-order. We show that neither is successful, and offer in their place a new theory: reflexive (...) imperativism. Our proposal is that an experience P feels pleasant in virtue of being constituted by a Command with reflexive imperative content, while an experience U feels unpleasant in virtue of being constituted by a Command with reflexive imperative content : More of P!Less of U! If you need a slogan: experiences have affective phenomenal character in virtue of commanding us Get more of me! Get less of me! (shrink)

Tracking representationalism explains the negative affective character of pain, and its capacity to motivate action, by reference to the representation of the badness for us of bodily damage. I argue that there is a more fitting instantiation of the tracking relation – the badness for us of extremely intense stimuli – and use this to motivate a non-reductive approach to the negative affective character of pain. The view of pain proposed here is supported by consideration of three related topics: the (...) pain caused when the body is damaged, reparative pain, and the messenger-shooting objection to tracking representationalism. (shrink)

This paper assesses whether Evaluativism, as a view about the nature of unpleasant pains, can meet a specific normative condition. The normative condition says whatever candidate state is offered as an analysis of unpleasant pain should be intrinsically phenomenally bad for its subject to be in. I first articulate a method reflecting this condition, called the normative contrast method, and then frame Evaluativism in detail. The view is then tested through this method. I show that Evaluativism can explain why cases (...) of evaluative thought, with the same contents as unpleasant pains, are not intrinsically phenomenally bad for their subjects to be in by appeal to intentional modes. However, I argue the appeal to perceptuality, which is central to this response is problematic, and therefore it remains unclear whether Evaluativism, as standardly articulated, can meet the normative condition on unpleasant pains. (shrink)

Over recent decades, pain has received increasing attention as – with ever greater sophistication and rigour – theorists have tried to answer the deep and difficult questions it poses. What is pain’s nature? What is its point? In what sense is it bad? The papers collected in this volume are a contribution to that effort ...

Several theorists have defended that unpleasantness can be explained by appealing to (intrinsic, simultaneous, de re) desires for certain experiences not to be occurring. In a nutshell, experiences are unpleasant because we do not want them, and not vice versa. A common criticism for this approach takes the form of a Euthyphro dilemma. Even if there is a solution for this criticism, I argue that this type of approach is limited in two important ways. It cannot provide an explanation for: (...) i) the motivation, from a psychological conscious point of view, nor ii) a non-instrumental justification, for having the relevant desires. The lack of these explanations is relevant since these are precisely the type clarifications that we would expect from a theory about unpleasantness. (shrink)

In this thesis I provide an account of the unpleasantness of pain. In doing this, I shed light on the nature of pain and unpleasantness. I propose to understand the unpleasantness of pain based on the determinable-determinate distinction. Unpleasantness is a determinable phenomenal property of mental states that entails badness. I propose that an unpleasant pain experience has two phenomenal properties: i) the phenomenal property of being a pain, and ii) a phenomenal determinate property (u1, u2, u3, etc.) of the (...) unpleasantness determinable. According to this theory unpleasant pains feel bad, and this explains why we are motivated and justified in avoiding them. This explains, for example, why we are motivated and justified to take painkillers. This theory allows us to account for the heterogeneity of unpleasantness, i.e., we can explain how different unpleasant experiences feel unpleasant even if they feel so different. -/- The thesis is organised into seven chapters and divided by three main themes: i) what the unpleasantness of pain consists in, ii) how we can account for the great phenomenal diversity among experiences of unpleasantness, and iii) which cases suggest that there could be pains that are not unpleasant. Broadly, the first two chapters deal with the first theme, where I analyse two reductive accounts of unpleasantness: the content theories and the desire theories. I deal with the second theme in the third and fourth chapter, where I analyse different theories that try to account for the phenomenal property of unpleasantness. In the fifth and sixth chapter, I focus on the third theme, where I consider different cases that suggest the existence of pains that are not unpleasant. In the final chapter, I offer a conclusion of the three main themes by providing my own view on the unpleasantness of pain. (shrink)

The official definition of ‘pain’ by the International Association for the Study of Pain (IASP) hasn’t seen much revision since its publication in 1979. There have been various criticisms of the definition in the literature from different quarters: that the definition implies a dubious metaphysical dualism, that it requires a strong form of consciousness as well as linguistic abilities, that it excludes many vulnerable groups that are otherwise perfectly capable of experiencing pain, that it has therefore unacceptable practical as well (...) as ethical consequences, that it is unhelpful to the health-care professional as an operational definition, that it is too narrow, and many others. In my view, most of these criticisms depend on misunderstandings or on uncharitable interpretations. My aim is to go over the definition, clarify some potential ambiguities, and argue that these criticisms don’t cut much ice. At the end, I will present a few slightly reworded versions of the definition that I claim are more felicitous and capture the original intended meaning by the members of the taxonomic committee in a much better and transparent way that avoids all the major extant criticisms in the literature. (Written for interdisciplinary audiences.). (shrink)

[Penultimate draft] I present the perceptualist/representationalist theories of pain in broad outline and critically examine them in light of a competing view according to which awareness of pain is essentially introspective. I end the essay with a positive sketch of a naturalistic proposal according to which pain experiences are intentional but not fully representational. This proposal makes sense of locating pains in body parts as well as taking pains as subjective experiences.

In various papers, Colin Klein has argued that pain experiences are commands. This monograph goes well beyond the papers, re-shaping his ‘imperativist’ view, setting it within a general account of ‘homeostatic sensations’, presenting new arguments, and criticising alternatives. Original, empirically informed, clear, and often persuasive, it is a lovely book.

Evaluativism is best thought of as a way of enriching a perceptual view of pain to account for pain’s unpleasantness or painfulness. Once it was common for philosophers to contrast pains with perceptual experiences (McGinn 1982; Rorty 1980). It was thought that perceptual experiences were intentional (or content-bearing, or about something), whereas pains were representationally blank. But today many of us reject this contrast. For us, your having a pain in your toe is a matter not of your sensing “pain-ly” (...) or encountering a sense-datum, but of your having an interoceptive experience representing (accurately or inaccurately) that your toe is in a particular experience-independent condition, such as undergoing a certain “disturbance” or being damaged or in danger (Armstrong 1962; Tye 1995). But even if such representational content makes an experience a pain, a further ingredient seems required to make the pain unpleasant. According to evaluativism, the further ingredient is the experience’s possession of evaluative content: its representing the bodily condition as bad for the subject. In this chapter, I elaborate evaluativism, locate it among alternatives, and explain its attractions and challenges. (shrink)

Both patients and clinicians frequently report problems around communicating and assessing pain. Patients express dissatisfaction with their doctors and doctors often find exchanges with chronic pain patients difficult and frustrating. This chapter thus asks how we could improve pain communication and thereby enhance outcomes for chronic pain patients. We argue that improving matters will require a better appreciation of the complex meaning of pain terms and of the variability and flexibility in how individuals think about pain. We start by examining (...) the various accounts of the meaning of pain terms that have been suggested within philosophy and suggest that, while each of the accounts captures something important about our use of pain terms, none is completely satisfactory. We propose that pain terms should be viewed as communicating complex meanings, which may change across different communicative contexts, and this in turn suggests that we should view our ordinary thought about pain as similarly complex. We then sketch what a view taking seriously this variability in meaning and thought might look like, which we call the “polyeidic” view. According to this view, individuals tacitly occupy divergent stances across a range of different dimensions of pain, with one agent, for instance, thinking of pain in a much more “bodycentric” kind of way, while another thinks of pain in a much more "mindcentric” way. The polyeidic view attempts to expand the multidimensionality recognised in, e.g., biopsychosocial models in two directions: first, it holds that the standard triumvirate— dividing sensory/cognitive/affective factors— needs to be enriched in order to capture important distinctions within the social and psychological dimensions. Second, the polyeidic view attempts to explain (at least in part) why modulation of experience by these social and psychological factors is possible in the first place. It does so by arguing that because the folk concept of pain is complex, different weightings of the different parts of the concept can modulate pain experience in a variety of ways. Finally, we argue that adopting a polyeidic approach to the meaning of pain would have a range of measurable clinical outcomes. (shrink)

This chapter (from Routledge's forthcoming handbook on the philosophy of pain) considers the question of whether people are always correct when they judge themselves to be in pain, or not in pain. While I don't show sympathy for traditional routes to the conclusion that people are "incorrigible" in their pain judgments, I explore--and perhaps even advocate--a different route to such incorrigibility. On this low road to incorrigibility, a sensory state's being judged unpleasant is what makes it a pain (or not).

I have laid out what seem to me to be the most promising arguments on opposing sides of the question of whether what humans regard as the first-person accessible aspects of pain could also be implemented in robots. I have emphasized the ways in which the thought experiments in the respective arguments attempt to marshal hypothetical first- person accessible evidence concerning how one’s own mental life appears to oneself. In the Chinese room argument, a crucial premise involves the thesis that (...) from a lack of it seeming that one is in pain, one can conclude that one is not in pain. There’s a counterpart thesis playing a crucial role in the prosthetic neurons argument, one asserting an entailment from its seeming that one is in pain to one’s being in pain. I further suggested that by adopting a HOT theory of consciousness, of the sort reviewed in Pereplyotchik’s chapter in the present volume, one is thereby in a better position to endorse the prosthetic neurons argument over the Chinese room argument than to make the opposite appraisal. (shrink)

This chapter defends an axiological theory of pain according to which pains are bodily episodes that are bad in some way. Section 1 introduces two standard assumptions about pain that the axiological theory constitutively rejects: (i) that pains are essentially tied to consciousness and (ii) that pains are not essentially tied to badness. Section 2 presents the axiological theory by contrast to these and provides a preliminary defense of it. Section 3 introduces the paradox of pain and argues that since (...) the axiological theory takes the location of pain at face value, it needs to grapple with the privacy, self-intimacy and incorrigibility of pain. Sections 4, 5 and 6 explain how the axiological theory may deal with each of these. (shrink)

Recent work on signaling has mostly focused on communication between organisms. The Lewis–Skyrms framework should be equally applicable to intra-organismic signaling. We present a Lewis–Skyrms signaling-game model of painful signaling, and use it to argue that the content of pain is predominantly imperative. We address several objections to the account, concluding that our model gives a productive framework within which to consider internal signaling.

will give an overview of the fascinating communication between G. W. Leibniz and Pierre Bayle on pre-established harmony and sudden change in the soul which started from Bayle’s footnote H to the article “Rorarius” in his Dictionnaire historique et critique (1697) and ended in 1706 with Bayle’s death. I will compare the views presented in the communication to Leibniz’s reflections on the soul in his partly concurrent Nouveaux essais sur l’entendement humain (1704) and argue that many topics in the communication (...) with Bayle are discussed with more details in Nouveaux essais. I also argue that the communication helped Leibniz to respond to Locke’s views concerning uneasiness in An Essay Concerning Human Understanding, II, xxi. Bayle himself, however, was not able to completely understand Leibniz’s views on spontaneity as he was unaware of the contents of the Nouveaux essais, especially the systematic role of petites perceptions in Leibniz’s philosophy of mind. I will also reflect on whether the controversy could have ended in agreement if it would have continued longer. (shrink)

The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including (potentially among others) expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed (...) consent influences the effects of treatment. This provides support for the authorized concealment and authorized deception paradigms, and perhaps even for outright deceptive placebo use. Second, doctors may easily fail to consider the potential benefits of conditioning, leading them to misjudge the trade-off between beneficence and autonomy. Third, how attentional-somatic feedback loops play out depends not only on the content of the informing process but also on its framing. This suggests a role for libertarian paternalism in clinical practice. (shrink)

Philosophers think of pain less and less as a paradigmatic instance of mentality, for which they seek a general account, and increasingly as a rich and fruitful topic in its own right. Pain raises specific questions: about mentality and consciousness certainly, but also about embodiment, affect, motivation, and value, to name but a few. The growth of philosophical interest in pain has gone hand-in-hand with the growth of pain science, which burgeoned in the 1960s. This is no accident: developments in (...) pain science have prompted philosophers to take account of empirical data, and to revisit their assumptions about pain. Pain, in short, demands interdisciplinary investigation, hence while this entry focuses on the philosophy of pain, it makes liberal reference to empirical literature along the way. This entry’s focus is on physical pains, that is pains that are felt in bodily locations, not emotional suffering more broadly, such as grief or disappointment. The entry also does not address pain’s place in ethical theories; its focus is rather on issues that arise within philosophy of mind. Even so, part of what makes pain such an interesting and important topic is that the questions it raises span boundaries, and normative questions concerning pain’s badness, on the one hand, and its value, on the other, are never far away. (shrink)

Sometimes the philosophical armchair gets bumped by empirical facts. So it is when thinking about pain. For good or ill (good, actually, as we shall see) most of us are intimately acquainted with physical pain, the kind you feel when you stand on a nail or burn your hand. And, from the armchair, it can seem blindingly obvious that pain is essentially unpleasant. There are of course unpleasant experiences that aren’t pains – nausea or itches, for example – but surely (...) there aren’t pains that don’t hurt, pains that are neutral or even pleasurable rather than unpleasant. Surely, indeed, there couldn’t be. For it is part of the very concept of a pain that a pain be unpleasant. Or so it has seemed to many. Yet over recent decades philosophers’ confidence in these putative truisms has been shaken by some fascinating cases from the clinic, the lab, and life. (shrink)

Imperativism is the view that the phenomenal character of the affective component of pains, orgasms, and pleasant or unpleasant sensory experience depends on their imperative intentional content. In this paper I canvass an imperativist treatment of pains as reason-conferring states.

Pain asymbolia is a rare condition caused by brain damage, usually in adulthood. Asymbolics feel pain but appear indifferent to it, and indifferent also to visual and verbal threats. How should we make sense of this? Nikola Grahek thinks asymbolics’ pains are abnormal, lacking a component that make normal pains unpleasant and motivating. Colin Klein thinks that what is abnormal is not asymbolics’ pains, but asymbolics: they have a psychological deficit making them unresponsive to unpleasant pain. I argue that an (...) illuminating account requires elements of both views. Asymbolic pains are indeed abnormal, but they are abnormal because asymbolics are. I agree with Klein that asymbolics are incapable of caring about their bodily integrity; but I argue against him that, if this is to explain not only their indifference to visual and verbal threat, but also their indifference to pain, we must do the following: (i) take asymbolics’ lack of bodily care not as an alternative to, but as an explanation of their pains’ missing a component, and (ii) claim that the missing component consists in evaluative content. Asymbolia, I conclude, reveals not only that unpleasant pain is composite, but that its ‘hedomotive component’ is evaluative. (shrink)

Compare your pain when immersing your hand in freezing water and your pleasure when you taste your favourite wine. The relationship seems obvious. Your pain experience is unpleasant, aversive, negative, and bad. Your experience of the wine is pleasant, attractive, positive, and good. Pain and pleasure are straightforwardly opposites. Or that, at any rate, can seem beyond doubt, and to leave little more to be said. But, in fact, it is not beyond doubt. And, true or false, it leaves a (...) good deal more to be said: about the nature of sensory affect; its relations to perception, motivation, and rationality; its value; and the mechanisms underlying it. Much is said about these matters in the contributions that follow. Here, in this introductory essay, we map the dialectical landscape and locate our contributors’ papers within it. (shrink)

What is the contrary of pleasure? “Pain” is one common answer. This paper argues that pleasure instead has two natural contraries: unpleasure and hedonic indifference. This view is defended by drawing attention to two often-neglected concepts: the formal relation of polar opposition and the psychological state of hedonic indifference. The existence of mixed feelings, it is argued, does not threaten the contrariety of pleasure and unpleasure.

Functionalism of robot pain claims that what is definitive of robot pain is functional role, defined as the causal relations pain has to noxious stimuli, behavior and other subjective states. Here, I propose that the only way to theorize role-functionalism of robot pain is in terms of type-identity theory. I argue that what makes a state pain for a neuro-robot at a time is the functional role it has in the robot at the time, and this state is type identical (...) to a specific circuit state. Support from an experimental study shows that if the neural network that controls a robot includes a specific 'emotion circuit', physical damage to the robot will cause the disposition to avoid movement, thereby enhancing fitness, compared to robots without the circuit. Thus, pain for a robot at a time is type identical to a specific circuit state. (shrink)

The unpleasantness of pain motivates action. Hence many philosophers have doubted that it can be accounted for purely in terms of pain’s possession of indicative representational content. Instead, they have explained it in terms of subjects’ inclinations to stop their pains, or in terms of pain’s imperative content. I claim that such “noncognitivist” accounts fail to accommodate unpleasant pain’s reason-giving force. What is needed, I argue, is a view on which pains are unpleasant, motivate, and provide reasons in virtue of (...) possessing content that is indeed indicative, but also, crucially, evaluative. (shrink)

It is widely thought that functionalism and the qualia theory are better positioned to accommodate the ‘affective’ aspect of pain phenomenology than representationalism. In this paper, we attempt to overturn this opinion by raising problems for both functionalism and the qualia theory on this score. With regard to functionalism, we argue that it gets the order of explanation wrong: pain experience gives rise to the effects it does because it hurts, and not the other way around. With regard to the (...) qualia theory, we argue that it fails to capture the sense in which pain 's affective phenomenology rationalises various bodily-directed beliefs, desires, and behaviours. Representationalism, in contrast, escapes both of these problems: it gets the order of explanation right and it explains how pain 's affective phenomenology can rationalise bodily-directed beliefs, desires, and behaviours. For this reason, we argue that representationalism has a significant advantage in the debates about pain 's affective phenomenology. We end the paper by examining objections, including the question of what representationalists should say about so-called ‘disassociation cases’, such as pain asymbolia. (shrink)